MRI abnormalities in first-episode schizophrenia: Association with neurological impairment

Pieri, J.; Gupta, Babu; Bagwell, W.W.; Haas, G.L.; Sweeney, J.A.; Schooler, Nina R.; Sanders, Richard D.; Pettegrew, Jay W.; Keshavan, Matcheri S.

doi:10.1016/0920-9964(95)95272-b

Schizophrenia Research

1995

DOI: 10.1016/0920-9964(95)95272-b

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MRI abnormalities in first-episode schizophrenia: Association with neurological impairment

J. Pieri¹,

Babu Gupta²,

W.W. Bagwell³

et al.

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Structural brain imaging in biological psychiatry

Lewis

1996

British Medical Bulletin

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The application of X-ray CT and magnetic resonance imaging to the study of brain structure in psychiatry research is reviewed. In schizophrenia, CT showed minor enlargements of fluid spaces; MR has shown volume reductions in medial temporal lobe structures and, most recently, general cortical grey matter. In affective disorders, subcortical white matter lesions seem to characterise particular subgroups. In childhood autism, no clear consensus has emerged despite earlier claims for cerebellar pathology. In dementia, medial temporal changes can be detected reliably in Alzheimer's disease and are of diagnostic and prognostic importance.

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Structural brain imaging in biological psychiatry

Lewis

1996

British Medical Bulletin

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Research and treatment strategies in first-episode psychoses: The Pittsburgh experience

et al. 1998

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Background Studies of first-episode patients allow investigation of the biological basis of psychotic disorders without the potential confounds of prior treatment and illness chronicity. Prospective studies of this population can clarify the impact of illness course and treatment on neurobiology.Method We summarise preliminary findings from our ongoing magnetic resonance imaging and spectroscopy studies of first-episode schizophrenia patients being conducted prospectively from index evaluations through a period of two years; during this period, patients were treated with either a conventional antipsychotic such as haloperidol, or the atypical risperidone.Results Baseline neurobiological evaluations in first-episode schizophrenia patients have revealed evidence for structural and functional brain abnormalities consistent with a neurodevelopmental model of this illness. Our preliminary data support the value of risperidone as an antipsychotic drug of first choice among patients with early schizophrenic illness.Conclusions Focused studies of first-episode patients have the potential to unravel pathophysiology of schizophrenic illness. Such knowledge is critical for more effective early detection, intervention and even prevention of this enigmatic disorder.

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Prevention of Schizophrenia

2005

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Schizophrenia is a serious mental disorder with a profound impact on patients, their caregivers and society. It is also an expensive disorder to treat, despite being relatively rare. In this paper, prevention of schizophrenia is described in terms of primary, secondary and tertiary prevention. Schizophrenia is regarded as a neurodevelopmental disorder with different phases. Primary prevention essentially involves education programmes about the association of obstetric complications and the increased risk of schizophrenia. Secondary prevention involves intervention at the prodromal phase. We review the literature and discuss the evidence relating to intervention in this phase of the illness. Early intervention could result in reduction in morbidity and better quality of life for the patients and their families. The prodromal phase can now be identified, based on current symptoms, with reliability and predictive validity for the risk of development of schizophrenia in the following year. We also discuss possible risks faced by prodromal patients, such as unnecessary stigmatisation, and the role of drug treatment during intervention at this stage. Any recommendation that anti-psychotic medications be routinely prescribed in this phase should be supported by more research work. Drug and psychosocial intervention is indicated as part of tertiary prevention to prevent further disability in the illness.

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MRI abnormalities in first-episode schizophrenia: Association with neurological impairment

Cited by 3 publications

References 0 publications

Structural brain imaging in biological psychiatry

Structural brain imaging in biological psychiatry

Research and treatment strategies in first-episode psychoses: The Pittsburgh experience

Prevention of Schizophrenia

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